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Related Experiment Videos

Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?

Shyam Vedantam1, Sunil Amin2, Ben Maher3,4

  • 1Department of Medicine, University of Miami, Miami, FL, USA.

Clinical Endoscopy
|February 3, 2022
PubMed
Summary

Endoscopic retrograde cholangiopancreatography (ERCP) cholangiogram interpretation accuracy increases with higher annual procedure volumes. Experience significantly impacts the correct identification of complex findings, suggesting interpretation should be a key performance indicator (KPI) for ERCP training.

Keywords:
CholangiogramsEndoscopic retrograde cholangiopancreatographyKey performance indicatorsTraining

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Medical Education
  • Radiology

Background:

  • Cholangiogram interpretation is not a standard key performance indicator (KPI) in endoscopic retrograde cholangiopancreatography (ERCP) training.
  • National societies propose varying annual ERCP case volumes for maintaining competence.

Purpose of the Study:

  • To investigate the correlation between correct ERCP cholangiogram interpretation and the endoscopist's experience.
  • To evaluate if increased annual ERCP procedural volume enhances diagnostic accuracy in cholangiogram interpretation.

Main Methods:

  • A survey was administered to 150 gastroenterologists (ERCPists) to assess their ability to interpret ERCP cholangiographic findings.
  • Participants were divided into three groups: Trainees (n=50), Consultants performing >75 ERCPs/year (n=50), and Consultants performing >100 ERCPs/year (n=50).

Main Results:

  • Trainees demonstrated lower accuracy than both consultant groups in identifying most cholangiographic findings, except for extrahepatic choledocholithiasis.
  • Consultants performing >100 ERCPs/year showed superior interpretation skills compared to those performing >75 ERCPs/year, particularly for Strasberg type A and B bile leaks and Bismuth type 2 hilar strictures.

Conclusions:

  • Higher annual ERCP case volumes are associated with improved cholangiogram interpretation accuracy.
  • Increased procedural volume may enhance the ability to correctly interpret challenging cholangiographic findings.
  • Cholangiogram interpretation accuracy should be considered a key performance indicator (KPI) for ERCP training, alongside bile duct cannulation.